Five-Year Outcomes with PCI Guided by Fractional Flow Reserve

Key Points

• To evaluate the 5-year clinical outcomes of an initial fractional flow reserve (FFR)-guided PCI strategy compared with medical therapy alone in patients with stable coronary artery disease.
• Randomized clinical trial (FAME 2; ClinicalTrials.gov number, NCT01132495) assessing patients with stable coronary artery disease across a 5-year follow-up.
• Evaluated an initial strategy of FFR-guided percutaneous coronary intervention (PCI) combined with medical therapy versus medical therapy alone.
• Tracked outcomes for the primary composite end point of death, myocardial infarction, or urgent revascularization, as well as outcomes in patients without hemodynamically significant stenoses.
• Initial FFR-guided PCI was associated with a significantly lower rate of the composite primary endpoint of death, myocardial infarction, or urgent revascularization at 5 years compared with medical therapy alone.
• Patients lacking hemodynamically significant stenoses demonstrated favorable long-term clinical outcomes when managed with medical therapy alone.